Pain management for post-treatment survivors of complex cancers: a qualitative study of opioids and cannabis

Papers of special note have been highlighted as: •• of considerable interest

References

• 1. Howlader N, Noone A, Krapcho M et al. SEER Cancer Statistics Review, 1975–2018. (2021). Available from: https://seer.cancer.gov/csr/1975_2018/
  Google Scholar
• 2. Miller KD, Nogueira L, Devasia T et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J. Clin. 72(5), 409–436 (2022).
  MedlineGoogle Scholar
• 3. Paice JA, Lacchetti C, Bruera E et al. Management of chronic pain in survivors of adult cancers: ASCO Clinical Practice Guideline Summary. J. Oncol. Pract. 12(8), 757–762 (2016). •• This clinical practice guideline summarizes the recommendations for post-treatment pain management, including a description of the paucity of evidence regarding cannabis and opioids in this setting.
  Google Scholar
• 4. Glare PA, Davies PS, Finlay E et al. Pain in cancer survivors. J. Clin. Oncol. 32(16), 1739–1747 (2014).
  Medline CASGoogle Scholar
• 5. Green CR, Hart-Johnson T, Loeffler DR. Cancer-related chronic pain: examining quality of life in diverse cancer survivors. Cancer 117(9), 1994–2003 (2011).
  MedlineGoogle Scholar
• 6. Mao JJ, Bao T et al. Symptom burden among cancer survivors: impact of age and comorbidity. J. Am. Board Fam. Med. 20(5), 434–443 (2007).
  MedlineGoogle Scholar
• 7. Sanford NN, Butler SS et al. Prevalence of chronic pain among cancer survivors in the United States, 2010–2017. Cancer 125(23), 4310–4318 (2019).
  MedlineGoogle Scholar
• 8. Adelstein DJ, Wagner H et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J. Clin. Oncol. 21(1), 92–98 (2003).
  MedlineGoogle Scholar
• 9. Denis F, Bardet E et al. Final Results of the 94-01 French Head and Neck Oncology and Radiotherapy Group Randomized Trial Comparing Radiotherapy Alone With Concomitant Radiochemotherapy in Advanced-Stage Oropharynx Carcinoma. J. Clin. Oncol. 22(1), 69–76 (2004).
  MedlineGoogle Scholar
• 10. Yabroff KR, Clauser S, Davis WW, & Brown ML. Burden of illness in cancer survivors: findings from a population-based national sample. J. Natl Cancer Inst. 96(17), 1322–1330 (2004).
  MedlineGoogle Scholar
• 11. Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M. It's not over when it's over: long-term symptoms in cancer survivors--a systematic review. Int. J. Psychiatry Med. 40(2), 163–181 (2010).
  MedlineGoogle Scholar
• 12. Stricker CT, Jacobs LA. Physical late effects in adult cancer survivors. Oncology (Williston Park). 22(Suppl. 8 Nurse Ed), 33–41 (2008).
  MedlineGoogle Scholar
• 13. Stein KD, Syrjala KL, Andrykowski MA. Physical and psychological long-term and late effects of cancer. Cancer 112(Suppl. 11), 2577–2592 (2008).
  MedlineGoogle Scholar
• 14. Bjordal K, Ahlner-Elmqvist M et al. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J. Clin. Oncol. 17(3), 1008–1019 (1999).
  Medline CASGoogle Scholar
• 15. Ringash J. Survivorship and Quality of Life in Head and Neck Cancer. J. Clin. Oncol. 33(29), 3322–3327 (2015).
  MedlineGoogle Scholar
• 16. Montazeri A, Gillis CR, McEwen J. Quality of life in patients with lung cancer: a review of literature from 1970 to 1995. Chest 113(2), 467–481 (1998).
  Medline CASGoogle Scholar
• 17. Bezjak A, Ding K et al. Quality-of-life outcomes for adjuvant chemotherapy in early-stage non-small-cell lung cancer: results from a randomized trial, JBR.10. J. Clin. Oncol. 26(31), 5052–5059 (2008).
  MedlineGoogle Scholar
• 18. Robnett TJ, Machtay M, Vines EF, McKenna MG, Algazy KM, McKenna W G. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int. J. Radiat. Oncol. Biol. Phys. 48(1), 89–94 (2000).
  Medline CASGoogle Scholar
• 19. Vijayvergia N, Shah PC, Denlinger CS. Survivorship in non-small cell lung cancer: challenges faced and steps forward. J. Natl Compr. Canc Netw. 13(9), 1151–1161 (2015).
  Medline CASGoogle Scholar
• 20. Ko CY, Maggard M, Livingston EH. Evaluating health utility in patients with melanoma, breast cancer, colon cancer, and lung cancer: a nationwide, population-based assessment. J. Surg. Res. 114(1), 1–5 (2003).
  MedlineGoogle Scholar
• 21. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin. Proc. 83(5), 584–594 (2008).
  MedlineGoogle Scholar
• 22. Sandfeld-Paulsen B, Meldgaard P, Aggerholm-Pedersen N. Comorbidity in lung cancer: a prospective cohort study of self-reported versus register-based comorbidity. J. Thorac. Oncol. 13(1), 54–62 (2018).
  MedlineGoogle Scholar
• 23. Alexander M, Evans SM, Stirling RG et al. The influence of comorbidity and the simplified comorbidity score on overall survival in non-small cell lung cancer-a prospective cohort study. J. Thorac. Oncol. 11(5), 748–757 (2016).
  MedlineGoogle Scholar
• 24. Nilsen ML, Scheff N et al. Late and long-term treatment-related effects and survivorship for head and neck cancer patients. Curr. Treat. Options Oncol. 21(12), 92 (2020).
  MedlineGoogle Scholar
• 25. Nguyen NA, Ringash J. Head and neck cancer survivorship care: a review of the current guidelines and remaining unmet needs. Curr. Treat. Options Oncol. 19(8), 44 (2018).
  MedlineGoogle Scholar
• 26. Ringash J. Quality of life in head and neck cancer: where we are, and where we are going. Int. J. Radiat. Oncol. Biol. Phys. 97(4), 662–666 (2017).
  MedlineGoogle Scholar
• 27. Rathod S, Livergant J, Klein J, Witterick I, Ringash J. A systematic review of quality of life in head and neck cancer treated with surgery with or without adjuvant treatment. Oral Oncol. 51(10), 888–900 (2015).
  MedlineGoogle Scholar
• 28. Pozo CL, Morgan MA, Gray JE. Survivorship issues for patients with lung cancer. Cancer Control 21(1), 40–50 (2014).
  MedlineGoogle Scholar
• 29. Cochrane A, Woods S, Dunne S, Gallagher P. Unmet supportive care needs associated with quality of life for people with lung cancer: a systematic review of the evidence 2007–2020. Eur. J. Cancer Care (Engl). 31(1), e13525 (2022).
  MedlineGoogle Scholar
• 30. Poghosyan H, Sheldon LK, Leveille SG, Cooley ME. Health-related quality of life after surgical treatment in patients with non-small cell lung cancer: a systematic review. Lung Cancer 81(1), 11–26 (2013).
  MedlineGoogle Scholar
• 31. Hechtner M, Eichler M, Wehler B et al. Quality of life in NSCLC survivors - a multicenter cross-sectional study. J. Thorac. Oncol. 14(3), 420–435 (2019).
  MedlineGoogle Scholar
• 32. Ringash J, Bernstein LJ, Devins G et al. Head and neck cancer survivorship: learning the needs, meeting the needs. Semin. Radiat. Oncol. 28(1), 64–74 (2018).
  MedlineGoogle Scholar
• 33. Chuang SC, Scelo G, Tonita JM et al. Risk of second primary cancer among patients with head and neck cancers: a pooled analysis of 13 cancer registries. Int. J. Cancer 123(10), 2390–2396 (2008).
  Medline CASGoogle Scholar
• 34. Cooper JS, Pajak TF, Rubin P et al. Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience. International Journal of Radiation Oncology*Biology*Physics. 17(3), 449–456 (1989).
  Medline CASGoogle Scholar
• 35. Baxi SS, Patil SM et al. Causes of death in long-term survivors of head and neck cancer. Cancer 120(10), 1507–1513 (2014).
  MedlineGoogle Scholar
• 36. Plummer C, Henderson RD, O'Sullivan JD, Read SJ. Ischemic stroke and transient ischemic attack after head and neck radiotherapy: a review. Stroke 42(9), 2410–2418 (2011).
  MedlineGoogle Scholar
• 37. Rose BS, Jeong JH, Nath SK, Lu SM, Mell LK. Population-based study of competing mortality in head and neck cancer. J. Clin. Oncol. 29(26), 3503–3509 (2011).
  MedlineGoogle Scholar
• 38. Argiris A, Brockstein BE, Haraf DJ et al. Competing causes of death and second primary tumors in patients with locoregionally advanced head and neck cancer treated with chemoradiotherapy. Clin. Cancer Res. 10(6), 1956–1962 (2004).
  Medline CASGoogle Scholar
• 39. Morris LG, Sikora AG, Patel SG et al. Second primary cancers after an index head and neck cancer: subsite-specific trends in the era of human papillomavirus-associated oropharyngeal cancer. J. Clin. Oncol. 29(6), 739–746 (2011).
  MedlineGoogle Scholar
• 40. Alberg AJ, Ford JG, Samet JM, Spivack, SD. Epidemiology of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 143(Suppl. 5), e1S–e29S (2013).
  MedlineGoogle Scholar
• 41. Fischer DJ, Villines D, Kim YO, Epstein JB, Wilkie DJ. Anxiety, depression, and pain: differences by primary cancer. Support. Care Cancer 18(7), 801–810 (2010).
  MedlineGoogle Scholar
• 42. Macfarlane TV, Wirth T, Ranasinghe S, Ah-See KW, Renny N, Hurman D. Head and neck cancer pain: systematic review of prevalence and associated factors. J. Oral Maxillofac. Res. 3(1), e1 (2012).
  Google Scholar
• 43. Taylor JC, Ronis DL et al. Disability in patients with head and neck cancer. Arch. Otolaryngol. Head Neck Surg. 130(6), 764–769 (2004).
  MedlineGoogle Scholar
• 44. Terrell JE, Fowler KE et al. Clinical predictors of quality of life in patients with head and neck cancer. Arch. Otolaryngol. Head Neck Surg. 130(4), 401–408 (2004).
  MedlineGoogle Scholar
• 45. Duke R, Indresano AT et al. Dental status and quality of life in long-term head and neck cancer survivors. The Laryngoscope 115(4), 678–683 (2005).
  MedlineGoogle Scholar
• 46. Murphy BA, Gilbert J, Ridner SH. Systemic and global toxicities of head and neck treatment. Expert Rev. Anticancer Ther. 7(7), 1043–1053 (2007).
  MedlineGoogle Scholar
• 47. Campbell BH, Marbella AM, Myers KB, Kuhn JC, Layde PM. Aspiration, weight loss, and quality of life in head and neck cancer survivors. Arch. Otolaryngol. Head Neck Surg. 130(9), 1100–1103 (2004).
  MedlineGoogle Scholar
• 48. Chen AY, Bishop-Leone J. et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson Dysphagia Inventory. Arch. Otolaryngol. Head Neck Surg. 127(7), 870–876 (2001).
  MedlineGoogle Scholar
• 49. Skoner JM, Andersen PE, Cohen JI, Holland JJ, Hansen E, Wax MK. Swallowing function and tracheotomy dependence after combined-modality treatment including free tissue transfer for advanced-stage oropharyngeal cancer. The Laryngoscope 113(8), 1294–1298 (2003).
  MedlineGoogle Scholar
• 50. Curi MM, Oliveira dos Santos M, Feher O, Faria JCM, Kowalski LP, Rodrigues ML. Management of extensive osteoradionecrosis of the mandible with radical resection and immediate microvascular reconstruction. J. Oral Maxillofac. Surg. 65(3), 434–438 (2007).
  MedlineGoogle Scholar
• 51. Cramer JD, Johnson JT, Nilsen ML. Pain in head and neck cancer survivors: prevalence, predictors, and quality-of-life impact. 159(5), 853–858 (2018).
  Google Scholar
• 52. Yang P, Wampfler JA et al. Quality of life and symptom burden among long-term lung cancer survivors. J. Thorac. Oncol. 7(1), 64–70 (2012).
  MedlineGoogle Scholar
• 53. Cheung WY. Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists. J. Cancer Surviv. 7(3), 343–354 (2013).
  MedlineGoogle Scholar
• 54. Hewitt MGreenfield SStovall E. (Eds). From Cancer Patient to Cancer Survivor: Lost in Transition. Institute of Medicine and National Research Council, Washington DC, USA (2005).
  Google Scholar
• 55. Salz T, Lavery J, Lipitz-Snyderman A et al. Variation in use of surveillance colonoscopy among colorectal cancer survivors in the United States. BMC Health Serv. Res. 10, 256 (2010).
  MedlineGoogle Scholar
• 56. Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer 101(8), 1712–1719 (2004).
  MedlineGoogle Scholar
• 57. Snyder CF, Frick KD, Herbert RJ et al. Quality of care for comorbid conditions during the transition to survivorship: differences between cancer survivors and noncancer controls. J. Clin. Oncol. 31(9), 1140–1148 (2013).
  MedlineGoogle Scholar
• 58. Tringale KR, Salans M, Marshall DC, Shi Y, Hattangadi-Gluth, JA.. The role of cancer in marijuana and prescription opioid use in the United States: a population-based analysis from 2005 to 2014. Cancer (2019).
  MedlineGoogle Scholar
• 59. Pergam SA, Woodfield MC, Lee CM et al. Cannabis use among patients at a comprehensive cancer center in a state with legalized medicinal and recreational use. Cancer 123(22), 4488–4497 (2017).
  Medline CASGoogle Scholar
• 60. Tanco K, Kreis R et al. Attitudes and beliefs about medical usefulness and legalization of marijuana among cancer patients in a legalized and a nonlegalized state. J. Palliat. Med. 22(10), 1213–1220 (2019).
  MedlineGoogle Scholar
• 61. Hasin DS, Kerridge BT et al. Prevalence of Marijuana Use Disorders in the United States Between 2001–2002 and 2012–2013. JAMA Psychiatry 72(12), 1235–1242 (2015).
  MedlineGoogle Scholar
• 62. Hanganu B, Manoilescu IS et al. Controversial Link between Cannabis and Anticancer Treatments-Where Are We and Where Are We Going? A Systematic Review of the Literature. Cancers (Basel). 14(16), (2022).
  MedlineGoogle Scholar
• 63. Wilkie G, Sakr B, Rizack T. Medical Marijuana Use in Oncology: A Review. JAMA Oncol. 2(5), 670–675 (2016).
  MedlineGoogle Scholar
• 64. Boland EG, Bennett MI, Allgar V, Boland JW. Cannabinoids for adult cancer-related pain: systematic review and meta-analysis. BMJ Support Palliat. Care 10(1), 14–24 (2020).
  MedlineGoogle Scholar
• 65. Alderman B, Mukhopadhyay S et al. Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/consensus guidance on the use of cannabinoids for gastrointestinal symptoms in patients with cancer. Support. Care Cancer 31(1), 39 (2022).
  MedlineGoogle Scholar
• 66. Mao JJ, Bowman MA, Xie SX, Kadakia R, Farrar JT. Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology–ASCO Guideline. J. Clin. Oncol. 0(0), JCO.22.01357 (2022).
  Google Scholar
• 67. van den Beuken-van Everdingen MH, Joosten EA, Tjan-Heijnen VC, Janssen DJ. Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J. Pain Symptom Manage. 51(6), 1070–1090.e9 (2016).
  MedlineGoogle Scholar
• 68. Swarm RA, Anghelescu DL et al. Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J. Natl Compr. Canc. Netw. 17(8), 977–1007 (2019).
  Medline CASGoogle Scholar
• 69. Paice JA, Bruera E. Use of opioids for adults with pain from cancer or cancer treatment: ASCO guideline. J. Clin. Oncol. 41(4), 914–930 (2023).
  MedlineGoogle Scholar
• 70. Kriplani A, Mishra A et al. Trends in chronic opioid therapy among survivors of head and neck cancer. Head Neck 43(1), 223–228 (2021).
  MedlineGoogle Scholar
• 71. Salz T, Lipitz-Snyderman AN et al. Trends in opioid use among older survivors of colorectal, lung, and breast cancers. J. Clin. Oncol. 37(12), 1001–1011 (2019).
  Medline CASGoogle Scholar
• 72. Salz T, Gennarelli RL et al. Safety of opioid prescribing among older cancer survivors. Cancer 128(3), 570–578 (2022). •• This retrospective analysis of opioid use among cancer survivors highlights areas of concern for safety of long-term opioid use.
  MedlineGoogle Scholar
• 73. Corbin J, Strauss A. Basics of Qualitative Research (3rd ed.): Techniques and Procedures for Developing Grounded Theory. CA, USA (2008).
  Google Scholar
• 74. Foley G, Timonen V. Using Grounded Theory Method to Capture and Analyze Health Care Experiences. Health Serv. Res. 50(4), 1195–1210 (2015).
  MedlineGoogle Scholar
• 75. Dey I. Grounding Grounded Theory. Guidelines for Qualitative Inquiry. Emerald Group, Bingley, UK (2008).
  Google Scholar
• 76. Snyder CF, Herbert RJ, Neville BA, Blackford AL, Frick KD. Trends in follow-up and preventive care for colorectal cancer survivors. J. Gen. Intern. Med. 23(3), 254–259 (2008).
  MedlineGoogle Scholar
• 77. Snyder CF, Kantsiper ME et al. Prevention, screening, and surveillance care for breast cancer survivors compared with controls: changes from 1998 to 2002. J. Clin. Oncol. 27(7), 1054–1061 (2009).
  MedlineGoogle Scholar
• 78. Snyder CF, Kantsiper ME et al. Preventive care in prostate cancer patients: following diagnosis and for five-year survivors. J. Cancer Surviv. 5(3), 283–291 (2011).
  MedlineGoogle Scholar
• 79. Snyder CF, Herbert RJ et al. Comorbid condition care quality in cancer survivors: role of primary care and specialty providers and care coordination. J. Cancer Surviv. 9(4), 641–649 (2015). •• Using claims data, this study demonstrates the association between provider type and care quality for cancer survivors, which has implications for care coordination for pain management.
  MedlineGoogle Scholar
• 80. Klabunde CN, Earle CC et al. Physician roles in the cancer-related follow-up care of cancer survivors. Fam. Med. 45(7), 463–474 (2013).
  MedlineGoogle Scholar
• 81. Mariotto AB, Parsons H et al. Workforce Caring for Cancer Survivors in the United States: Estimates and Projections of Utilization. J. Natl Cancer Inst. 114(6), 837–844 (2022).
  MedlineGoogle Scholar
• 82. McLennan A, Subnis U et al. Health care provider preferences for, and barriers to, cannabis use in cancer care. Curr Oncol. 27(2), e199–e205 (2020).
  Medline CASGoogle Scholar
• 83. Patell R, Dodge L et al. Oncology Fellows' Clinical Discussions, Perceived Knowledge, and Formal Training Regarding Medical Cannabis Use: A National Survey Study. JCO Oncol Pract. Op2100714 (2022). •• This survey study of oncology fellows demonstrates the lack of training around cannabis use.
  Google Scholar
• 84. Braun IM, Abrams DI, Blansky SE, Pergam SA. Cannabis and the Cancer Patient. J. Natl Cancer Inst. Monogr. 2021(58), 68–77 (2021).
  MedlineGoogle Scholar
• 85. Sun V, Borneman T, Piper B, Koczywas M, Ferrell B. Barriers to pain assessment and management in cancer survivorship. J. Cancer Surviv. 2(1), 65–71 (2008).
  MedlineGoogle Scholar
• 86. Tyson DM Chavez MN Lake P et al. Perceptions of prescription opioid medication within the context of cancer survivorship and the opioid epidemic. J. Cancer Surviv. 15(4), 585-596 (2021).
  MedlineGoogle Scholar
• 87. Tyson DM Chavez MN Lubrano B et al. Understanding Cancer Survivors' Educational Needs About Prescription Opioid Medications: Implications for Cancer Education and Health Literacy. J. Cancer Educ. 36(2), 215-224 (2021).
  MedlineGoogle Scholar
• 88. Simard S, Humphris G et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J. Cancer Surviv. 7(3), 300–322 (2013).
  MedlineGoogle Scholar
• 89. Unseld M, Fellinger M et al. Prevalence of pain and its association with symptoms of post-traumatic stress disorder, depression, anxiety and distress in 846 cancer patients: a cross sectional study. Psychooncology 30(4), 504–510 (2021).
  MedlineGoogle Scholar
• 90. Brown LF, Theobald DE, Wu J, Tu W. The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain. Psychooncology 19(7), 734–741 (2010).
  MedlineGoogle Scholar
• 91. Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS. Chronic pain-associated depression: antecedent or consequence of chronic pain? A review. Clin. J. Pain 13(2), 116–137 (1997).
  Medline CASGoogle Scholar
• 92. Scott EL, Kroenke K, Wu J, Yu Z. Beneficial effects of improvement in depression, pain catastrophizing, and anxiety on pain outcomes: a 12-month longitudinal analysis. J. Pain 17(2), 215–222 (2016).
  MedlineGoogle Scholar
• 93. Gómez Penedo JM, Blättler L et al. The complex interplay of pain, depression, and anxiety symptoms in patients with chronic pain: a network approach. Clin. J. Pain 36(4), 249–259 (2020).
  MedlineGoogle Scholar
• 94. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann. Acad. Med. Singapore 23(2), 129–138 (1994).
  Medline CASGoogle Scholar
• 95. Andersen BL, Berman BS et al. Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults With Cancer: An American Society of Clinical Oncology Guideline Adaptation. J. Clin. Oncol. 32(15), 1605–1619 (2014).
  MedlineGoogle Scholar
• 96. Howell D, Oliver T et al. A pan-Canadian practice guideline and algorithm: screening, assessment, and supportive care of adults with cancer-related fatigue. Current oncology 20(3), 233–246 (2013).
  Google Scholar
• 97. Denlinger CS, Baker KS et al. Survivorship, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology. J. Natl Compr. Canc. Netw. 16(10), 1216–1247 (2018).
  Medline CASGoogle Scholar
• 98. Partridge AH, Jacobsen PB, Andersen BL. Challenges to Standardizing the Care for Adult Cancer Survivors: Highlighting ASCO's Fatigue and Anxiety and Depression Guidelines. Am. Soc. Clin. Oncol. Educ. Book 188–94 (2015).
  MedlineGoogle Scholar
• 99. Andersen BL, Berman BS et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J. Clin. Oncol. 32(15), 1605–1619 (2014).
  MedlineGoogle Scholar
• 100. Meghani SH, Byun E, Gallagher RM. Time to take stock: a meta-analysis and systematic review of analgesic treatment disparities for pain in the United States. Pain Med. 13(2), 150–174 (2012).
  MedlineGoogle Scholar
• 101. Sheehan BE, Grucza RA, Plunk AD. Association of racial disparity of cannabis possession arrests among adults and youths with statewide cannabis decriminalization and legalization. JAMA Health Forum 2(10), e213435 (2021).
  MedlineGoogle Scholar
• 102. Firth CL, Dilley JA, Darnell A, Lovrich NP. Did marijuana legalization in Washington State reduce racial disparities in adult marijuana arrests? Substance Use Misuse 54(9), 1582–1587 (2019).
  MedlineGoogle Scholar
• 103. Owusu-Bempah A, Luscombe A. Race, cannabis and the Canadian war on drugs: an examination of cannabis arrest data by race in five cities. Int. J. Drug Policy 91, 102937 (2021).
  MedlineGoogle Scholar
• 104. Rosenberg A, Groves AK, Blankenship KM. Comparing Black and White drug offenders: implications for racial disparities in criminal justice and reentry policy and programming. J. Drug Issues 47(1), 132–142 (2017).
  MedlineGoogle Scholar
• 105. Tran NK, Purtle J et al. The heterogeneous effect of marijuana decriminalization policy on arrest rates in Philadelphia, Pennsylvania, 2009–2018. Drug Alcohol Depend. 212, 108058 (2020).
  MedlineGoogle Scholar